A woman with a face mask and a woman without one

Should a person with dementia wear a face mask for coronavirus?

Due to coronavirus, many of us now wear face masks or coverings while out shopping or on public transport. Some people with dementia may not like wearing a face covering, or understand why they should wear one. Read our advice on how to help and who may be exempt from wearing a mask.

This article was first published on 7 July 2020 and most recently updated on 14 September 2020.

During the coronavirus pandemic we’ve seen health and social care staff wearing face masks as part of their protective personal equipment (PPE). Face coverings, worn by members of the wider public, are different. They come in many different styles and may be home-made.

Here’s what you need to know about face coverings and how to support a person with dementia who might struggle with them.

Why should I wear a face mask or face covering?

Wearing a face covering helps stop you spreading coronavirus to other people. If you wear a face covering you may also be a bit less likely to catch coronavirus from someone else. 

You must still keep your distance, and follow good hygiene. You must self-isolate and get tested if you become ill with coronavirus. Older people and those with dementia are at higher risk of severe illness if they catch coronavirus, so should be extra careful to follow guidance on staying safe. 

A face covering is particularly important in enclosed spaces, such as while out shopping or on public transport, and if you’re around strangers.

Even with distancing measures in place, people will often get closer in shops or on public transport. Without fresh air the virus is more concentrated in enclosed spaces. A face covering can help reduce some of this risk.

A person with dementia might consider wearing a face covering even just walking outdoors in the high street – it could make them feel safer. But you don’t have to wear a face covering in your own home, unless you’re unwell with the virus and self-isolating.

Where can I get a face mask, or how do I make a face covering?

The government has issued guidance on how to make and wear a cloth face covering

You can use a scarf or bandana, or make your own covering from an old T-shirt or piece of cotton. It should be comfortable and cover your nose and mouth. You may already wear a face covering such as niqab, and don’t need to make or buy one. 

You can also buy a basic face mask online or from a pharmacy or supermarket. 

Don’t buy special medical-grade face masks. Supply of these is needed for frontline care workers.

What does the UK law say on wearing a face covering?

It is now compulsory in England for anyone aged 11 or over to wear a face covering on public transport, in NHS facilities as a visitor or outpatient, and inside shops, museums, galleries, cinemas and places of worship.

Face coverings are required in Northern Ireland for those aged 13 and over on public transport and inside shops. In Wales, a face covering is required for anyone aged 11 or over on public transport, and in shops and indoor public places. 

These rules do not apply to a person with dementia if they have a ‘reasonable excuse’ not to wear a face covering. A reasonable excuse could be:

  • They cannot physically put on or wear a face covering.
  • Wearing the face covering would cause them severe distress.
  • Someone with them needs to read their lips to communicate.
  • They need to remove the face covering temporarily to eat, drink or take medication. 

If someone such as a ticket inspector or shop assistant challenges the person for not covering their face, explain that they have dementia and can’t. Showing one of our helpcards, or a hidden disabilities sunflower lanyard (available at participating supermarkets) or exemption card is also a good idea.

You can also print your own exemption card at home or download one to your smartphone from the government’s guidance page.

Need help explaining why a face mask can't be worn?

Carrying our helpcards may help you when out in the community. You can also wear a sunflower lanyard and face covering exempt card, both available from Hidden Disabilities. 

Order our helpcards Face covering exempt card

What if a person with dementia won’t wear a face covering?

It’s safer for everyone if we all follow the guidance on face coverings. If the person finds wearing a face covering difficult, try to understand why. 

Be patient and offer encouragement – if you show frustration or irritation, the person will pick up on this.

  • Do they simply forget why it’s needed? Consider a sign up by the door for when you go out. You may need to gently remind the person we’re still in a pandemic.
  • Does the mask fit comfortably? Try different styles or looser fastenings if it's too tight
  • Are they unhappy with the feel of the fabric? Try some different materials, maybe one made from a familiar garment (check with them first before cutting the fabric).
  • Do they pull the cover down? Try some distraction or positive reinforcement – how wearing a face covering helps to stop the spread of coronavirus and keep people well.
  • Are they anxious it will stop them breathing? Offer reassurance and show them that it won’t.
  • Is there a past experience that might make them fearful about wearing a mask (perhaps as a young child in the war)? Talk to them about it and try to find ways to reassure them.

If these still don’t work, and wearing the mask would cause the person distress, then you are within the law to give this as a reasonable excuse for the person not to cover their face.

How can I communicate if I have my face covered?

Whether the person themselves is wearing a face cover or not, you may still be wearing yours at times. This may be unsettling for the person because they cannot read your facial expressions. Or perhaps they can’t hear your voice as clearly.

Try these tips to help you communicate when your face is covered:

  • Follow our general rules for good communication – use short, simple phrases and hand gestures.
  • Be mindful that a face covering makes things different – you may need to adapt how you communicate.
  • Think carefully about your tone – be clear, calm and friendly. Speak a bit louder from behind the cover.
  • Smile – your eyes communicate genuine warmth even if you smile is hidden.
  • Think about non-verbal clues – your body language (calm, open, friendly) should match your words. Gently mirror the person’s gestures if that helps connect you.
  • Above all, be empathic. Try to understand how the person is feeling – ask them if possible – and support them as patiently as you can.

More coronavirus advice and support

If you need help living with or supporting somebody with dementia during the pandemic, we're here for you. See our latest coronavirus advice and read how we can support you.

Coronavirus advice How we can help

50 comments

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My husband has frontotemporal dementai and
lockdown meant losing all our/his external social activities.
He does not understand masks at all and has removed the ones I have tried with him whereas I think 6 months ago he could have. understood, I think. This means I cannot take him on a bus or tube or without the worry I might have to constantly explain. I want to take him to visit relatives because i think he would enjoy that (memories come into it); but this means we have to take public transport. Feels like a no win until there is a vaccine.

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My husband has frontotemporal dementai and
lockdown meant losing all our/his external social activities.
He does not understand masks at all and has removed the ones I have tried with him whereas I think 6 months ago he could have. understood, I think. This means I cannot take him on a bus or tube or without the worry I might have to constantly explain. I want to take him to visit relatives because i think he would enjoy that (memories come into it); but this means we have to take public transport. Feels like a no win until there is a vaccine.

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Hi Jane,

Thanks for your comment, and really sorry to hear about these difficulties with public transport.

Although wearing a face covering is encouraged, if your husband is not able to wear one he does not have to. If someone such as a ticket inspector or shop assistant challenges you, you're entitled to explain that he has dementia and can’t. Showing one of our helpcards might be helpful in this kind of situation: https://www.alzheimers.org.uk/get-support/publications-and-factsheets/h…

The Government has also made its own exemption card, which you can print at home or download to a smartphone from the government’s guidance page: https://www.gov.uk/government/publications/face-coverings-when-to-wear-…

I really hope these resources are helpful, Jane. It's important to keep up those social activities where possible, or those things that you can both safely enjoy while we're all spending more time indoors.

Remember we're here for you, so if you need any information, advice or support you can call our Dementia Connect support line. Talk to a trained dementia adviser by calling 0333 150 3456*.

*Opening hours

Monday to Wednesday 9am – 8pm
Thursday and Friday 9am – 5pm
Saturday and Sunday 10am – 4pm

Best wishes,

Alzheimer's Society blog team

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As some have already stated, this must be based in individual needs / circumstances. I have cared for my Mother whom has Alzheimer’s, as she has shielded since March. Today, I took her to the local supermarket- a place she loved and looked forward to browse around. I wore a mask, but it would be far to distressing for her to wear one. Again, as people have already stated in here, the information regarding masks suggests that are worn more to protect others. I was able to keep Mum at a safe distance from others, and I only observed 1 other person, elderly whom was not wearing a mask.

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I think the evidence suggests the value of wearing a mask is to protect others more than protect ones self There is of course the issue of not standing out when out and about and when most if not all are wearing one. So for me (and as with pretty much everything about someone living with dementia) it must be a very individual thing. The variables are infinite personal circumstances must apply. I own 2 care homes where we look after many people living with the condition. All have been offered a cloth mask to wear ( we are still virus free ) all our staff have been fully masked up for many weeks now and having our residents able to ‘join in’ feels important otherwise we are creating a very divided alien environment.

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Don’t forget that the government guidance says that people can remove their masks when communicating with someone with hearing loss. Many older people with dementia will also have problems with their hearing and be relying on lip shapes to understand speech. It’s vital that carers and family recognise this and act appropriately - staying 2 metres apart of course. Written by someone with hearing loss!

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Someone with Alzheimer’s should not have to wear a face mask as the could find it difficult to breathe and not understand why they have it on. Anyone with Asthma or another breathing problem do not have to wears them but this has not been made clear to. Many people who suffer from these problems.

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In the mobility shop staff insisted Dad wear a mask. He said he was hot and stifled and could not concentrate on finding his payment card or remember his pin. He could not lip-read what staff were saying. Shop staff said, "that's why I take my mask off in the shop". I was unable to lip-read what either of them were saying. As we were leaving Dad un-hooked his mask and that tangled in his hearing aid and flipped it across the car park and I had to go over and pick it up as Dad can't bend down safely. I was wearing a sunflower lanyard and was allowed to not wear a mask. Dad prefers to wear a mask and for us to struggle than wear a label round his neck highlighting his disability. It is really stressful, but also like a Month Python sketch too. When you go in a shop without a mask staff should not be offended when you reply to their mask challenge, "Nobody expects the Spanish Inquisition" which is a line from an old Python sketch.

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I was sent an email, with an attachment for people with breathing or other problems, to exempt them from wearing a face mask. Apparently it stated no one was checked out as to why they weren't wearing a mask, just as long as they carried a small statement saying " exempt from wearing a face mask, please keep your distance". I was sent the link, for a copy of the badge from a professional body. So please don't panic if you genuinely feel you can't wear a face covering. Just print yourself off an exemption notification. Or get someone to do it for you.

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These are challenging times that none of us have experienced before. But if my mum was still alive I'd prefer her to be safe outside our home and wear a mask or some form protection against covid19. I know she wouldnt understand why she had to wear it, as anyone else who is looking after a parent, relative or other family member they wont do something they dont want to or feel uncomfortable in doing. I'd try making it some kind of game that if she left it on I would give her a reward. Yeah I know its bribery but at least she would be as safe as I could make her. Even if I had to make the masks myself with material that she would pick out maybe then she would co operate to wear it.
We have to do everything we can to protect our family members that are already coping with a life threatening illness, but now we need to protect them even more.

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I’m sorry but that is the most disgusting comment I have ever read in my life.

My Mother was diagnosed with Alzheimer’s at the age of 49 she passed away 6 years later.

I would have never ever allowed my Mother to wear a mask and to put her through such abuse. It’s the exact same as trying to put a mask on a 4 year old.

How dare you make such a comment or advice to so many people who are suffering because of a disease that has a low mortality rate and is not even classed as a High Consequence Infectious Disease, check government guidance here https://www.gov.uk/guidance/high-consequence-infectious-diseases-hcid

Putting your loved one through such abuse when they are suffering with one of the most life changing illness I would say that all people with dementia are exempt.

We should not have them to have to adapt to our new draconian rules that don’t protect them.

Save our vulnerable do not take this advice!

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I was told by both my Respiratory Nurse and Doctor, that I have to wear a mask at all times, for my own protection. I struggle to wear a mask as I also have Emphysema and Bronchiectasis, but I guess it’s keeping me alive.

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I'm a Wellbeing Activity Co-ordinator in a hospital supporting people to live well with dementia across 3 busy wards. The only company they have had since the beginning have been NHS staff in PPE. While my team of 3 people havevto adhere to PPE we have A5 photos of ourselves wearing normal clothes and smiling pinned to our chests. It helps to reassure and calm our patients and a comment like "this is me under the mask... I'm happy to see you" is a great way of breaking the chain's of fear and uncertainty 😀

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Hi, I hope this link to the latest Government advice on the wearing of face-coverings/masks helps to alleviate the concerns of those who are unclear whether or not it is ok not to wear one. Many people will be exempt from wearing one (myself included) & will not need to prove their medical reasons for not wearing one. Thanks.
https://www.gov.uk/government/news/face-coverings-mandatory-in-shops-su…

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I am just resigned to leaving Mum at home and coming up with excuses as to why she can’t come with me. I’ve had a lot of practice over the last few months. Her chiropodist and dentist have both said she will not be permitted entry without a mask. I am trimming her hair myself. Exhausted and totally fed up.

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My partner is Asthmatic as well as Dementia so she finds it very stressful wearing a mask so now she wears a Exempt card and so far it's never been questioned either in the shops or on public transport.

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Where can we get a sunflower lanyard from please

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Hi Carole, thanks for your comment.

The sunflower lanyards are available here: https://hiddendisabilitiesstore.com/shop/sunflower-lanyards.html

We have some more information about the scheme here, which you may find helpful: https://www.alzheimers.org.uk/blog/hidden-disabilities-dementia-sunflow…

Hope this helps,

Alzheimer's Society blog team

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Anyone who is distressed by wearing mask doesn't have to. My mum has dementia and is hard of hearing so we both won't be wearing them! Staff won't challenge anyone so don't worry. If customers get funny a poke in the eye usually helps,!

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